Abstract: In recent decades there have been revolutionary technological advances in the management of traumatic spinal column injuries. Despite these advances, the basic principles of reduction and stabilization of vertebral fractures and dislocations remain similar to those proposed by ancient and medieval physicians. Theodoric of Bologna, in his text Chiurgica de Theodoric (ca. AD 1267), described an extracorporeal approach to the management of traumatic spinal column misalignments. Surprisingly, his techniques are still used in many instances by contemporary spine surgeons, despite the availability of a more advanced technological armamentarium than that existent in medieval times.

Introduction: The diagnosis and treatment of traumatic spinal column disorders was first described in the Edwin Smith Papyrus (2500 BC) and revisited during the Greek and Roman Eras, as exemplified by the practices of Hippocrates (460–370 BC) and Galen of Pergamon (ca. AD 129-210). These writings were preserved and reintroduced to medieval Europe by the Arabian School and its learned scholars, most notably Avicenna of Baghdad (ca. AD 979– 1037).

Theodoric of Bologna (ca. AD 1205–1298), also known as Bishop Theodoric of Bitonto (1262) and later of Cervia (1266), was familiar with the teachings and practices of Hippocrates, Galen, and Avicenna. He devoted much of his life to studying medicine and surgery and wrote a surgical text, Chiurgica de Theodoric, in which among general writings on medicine and surgery, he discussed the treatment of acute spinal column disorders. Theodoric taught that the reestablishment of proper alignment of vertebral bodies by reduction and stabilization was required to heal spine fractures and dislocations. The techniques he described are surprisingly similar to the general philosophy upheld by contemporary spine surgeons, who apply a different clinical armamentarium from that available to Theodoric.